ROUTINE PROCEDURES FOR SANITATION AND HYGIENE
WHEN HANDLING BODY FLUIDS
Definitions
1. Bloodborne Pathogens means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B virus (HBV) and human immunodeficiency virus (HIV).
2. Contaminated means the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface.
3. Contaminated Laundry means laundry that has been soiled with blood or other potentially infectious materials or may contain sharps.
4. Exposure Incident means a specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties.
5. Methods of Compliance - General-Universal precautions shall be observed to prevent contact with blood or other potentially infectious materials. Under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluids shall be considered potentially infectious materials.
6. Occupational Exposure means reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's duties.
Equipment Needed
Water Disposal Bags Baggies
Hand Soap Dust Pans/Brush/Broom Paper Towels
Towelettes Disposable Gloves Utility Gloves
Trash Cans & Plastic Liners Mops & Buckets
Sanitary Napkin Container
Disinfectant - Should use one or more of these:
A. Sodium hypochlorite solution (household bleach)
One (1) part bleach to ten (10) parts water
Ex: 1½ cups bleach to 1 gallon of water
Needs to be prepared each time used on inanimate objects.
B. ViroGuard-Q - Distributed by Health Services
One (1) oz. of ViroGuard-Q to 128 oz. of water.
ViroGuard-Q is a germicidal product that is to be used on inanimate objects. ViroGuard-Q has bactericidal efficacy and fungicidal efficacy, mildew stat efficacy, virucidal efficacy, and sanitizing efficacy.
C. Hydrogen Peroxide 3% - to be used on skin surfaces.
ROUTINE PROCEDURES FOR SANITATION AND HYGIENE
WHEN HANDLING BODY FLUIDS (Cont.)
D. Isopropyl Alcohol - to be used on some skin surfaces and for rinsing the hands.
E. Sanitary absorbing agent (e.g., chlora-sorb).
Procedure
1. General
A. Wear disposable gloves before making contact with body fluids during care, treatment, and all cleaning procedures.
B. Discard gloves after each use.
C. Wash hands with germicidal soap after handling fluids and contaminated articles, whether or not gloves are worn.
D. Discard disposable items including tampons, used bandages, and dressings in plastic lined trash containers; close bags and discard daily.
E. Do not reuse plastic trash bags.
F. Use disposable items to handle body fluids whenever possible.
G. Use paper towels to pick up and discard any solid waste materials such as vomitus or feces.
H. Use general-purpose utility gloves (e.g., rubber household gloves) for housekeeping chores involving potential blood contacts and for general cleaning. Utility gloves can be cleaned and reused but should be discarded if they are peeling, cracked or discolored, or if they have punctures, tears or other evidence of deterioration.
2. Handwashing
A. Use germicidal soap and running water. Soap suspends easily removable soil and microorganisms, allowing them to be washed and rinsed away.
B. Rub hands together for approximately ten (10) seconds to work up a lather.
C. Scrub between fingers, knuckles, back of the hands and nails. Nails should be short and trimmed. Jewelry should not be worn.
D. Rinse hands under running water. Running water is necessary to carry away debris and dirt.
ROUTINE PROCEDURES FOR SANITATION AND HYGIENE
WHEN HANDLING BODY FLUIDS (Cont.)
E. Use paper towels to thoroughly dry hands.
F. Use paper towel to turn water off, discard paper towel.
3. Washable Surfaces (bottles, dishes, toys, tables, desks, etc.)
A. Use ViroGuard-Q solution or use household bleach solution, mixed fresh. Scrub as needed.
B. Rinse with water.
C. Allow to air dry.
D. When bleach solution is used, handle carefully.
1. Gloves should be worn since the solution is irritating to the skin.
2. Avoid applying to metal, since it will corrode most metals.
E. Toys that are placed in children’s mouths should be cleaned with water and detergent, disinfected, and rinsed before handling by another child.
F. All frequently touched toys should be cleaned and disinfected daily.
G. The use of soft, non-washable toys in classrooms should be discouraged.
4. Floors
A. Use household bleach solution, mixed fresh, or multi-purpose disinfectant.
B. Use the two (2) bucket system: One bucket to wash the soiled surface and one bucket to rinse, as follows:
1. In bucket #1, dip, wring, mop up vomitus, blood, etc.
2. Dip, wring, and mop once more.
3. Dip and wring out mop in bucket #1.
4. Put mop into bucket #2 (rinse bucket) that has clean bleach solution.
5. Mop or rinse area.
6. Return mop to bucket #2 to wring out. This keeps the rinse bucket clean for second spill in the area.
7. After spills are cleaned, proceed with #3.
C. Soak mop in the bleach solution after use.
D. After cleanup is completed, discard contents of bucket #1. Bucket #2 is now bucket #1; mix fresh bleach solution for bucket #2.
ROUTINE PROCEDURES FOR SANITATION AND HYGIENE
WHEN HANDLING BODY FLUIDS (Cont.)
E. Water and disposable cleaning equipment should be placed in a toilet or plastic bag, as indicated.
F. Rinse nondisposable cleaning equipment (dustpan, buckets) in disinfectant.
G. Dispose of disinfectant solution down the drainpipe.
H. Remove gloves, if worn, and discard in the appropriate receptacle.
I. Wash hands as described above.
5. Non-Washable Surfaces (rugs and upholstery, etc.)
A. Apply sanitary absorbing agent, let dry, vacuum.
B. If necessary, use broom and dustpan to remove soiled materials.
C. Apply rug or upholstery shampoo as directed. Re-vacuum according to directions on shampoo.
D. Spray soiled area with ViroGuard-Q solution, air dry.
E. Clean dustpan and broom, if used. Rinse in ViroGuard-Q solution or household bleach solution.
F. Wash hands as described above.
6. Soiled Washable Materials (clothing, towels, uniforms, etc.)
A. Rinse items under running water, using gloved hands, if appropriate.
B. Place items in plastic bag and seal until items are washed. Plastic bags containing soiled, washable material must be clearly identified.
C. Wash hands as described above.
D. Wipe sink with paper towels, discard towels.
E. Machine wash soiled items separately.
1. If material is bleachable, add ½ cup bleach to the wash cycle. If it is not bleachable, add ½ cup nonchlorine bleach (Clorox II/Borateem) to the wash cycle.
2. Wash in hot water: 160° F for 25 minutes, using detergent with disinfecting agent.
3. Discard plastic bag.
4. After handling soiled items, wash hands as described above.
ROUTINE PROCEDURES FOR SANITATION AND HYGIENE
WHEN HANDLING BODY FLUIDS (Cont.)
7. To Clean Blood or Body Fluid Spills (blood from nose, mouth, and skin lesions)
A. Put on gloves.
B. Use disposable wipes, cotton balls, or gauze pads which have been immersed in 3% peroxide.
C. Proceed to clean blood spills with the solution soaked materials.
D. Place soiled materials in a plastic bag for disposal.
E. Remove gloves, include with soiled materials and discard.
F. Wash hands as described above.
8. Toileting and Diapering
A. Toileting and toilet training equipment should be maintained in a sanitary condition.
B. Diaper changing surfaces should be nonporous and sanitized between uses for different children.
C. Soiled disposable diapers or soiled disposable wiping cloths should be disposed of in a secure plastic lined container.
D. Diapers should be able to contain urine and stool and minimize fecal contamination of the children, providers, and environmental surfaces and objects.
E. Diapers should have an absorbent inner lining attached to an outer covering made of waterproof material that prevents escape of feces and urine. Outer and inner lining must be changed as a unit and not reused.
F. Fecal contents may be placed in toilet, but diapers must not be rinsed. Preferably, dispose of diaper and contents as a total unit.
G. Diaper changing areas should never be located in food preparation areas and should never be used for temporary placement of foods.
9. Potty Chairs
A. Potty chairs must be emptied into a toilet after each use, cleaned in a utility sink, and disinfected after each use.
B. Gloves should be used if wiping a child. Leave gloves on until cleaning procedure is finished.
ROUTINE PROCEDURES FOR SANITATION AND HYGIENE
WHEN HANDLING BODY FLUIDS (Cont.)
C. Staff should sanitize potty chairs, flush toilets, and diaper changing areas with the household bleach solution or ViroGuard-Q solution.
D. Wash hands as described above.
10. Sleeping Equipment
A. Each item should be used by only one child.
B. The sleeping equipment should be cleaned and sanitized prior to assignment to another child.
C. Crib mattresses should be cleaned and sanitized when soiled or wet.
D. Sleeping mats should be stored so that contact with the surface of another mat does not occur.
E. Bedding should be assigned to each child and cleaned when soiled or wet.
11. General Information
A. CPR - Use disposable mouth piece and/or face shield (will be kept in the clinic).
B. ViroGuard-Q will be requested from the school and kept in the clinic in a spray bottle, ready for use.
C. Prepare a "cleanup baggie" by placing in a baggie a towelette moistened with hydrogen peroxide. Keep cleanup baggie and gloves in your desk or pocket. Use for recess or duty, if not used pass it to the next person on the duty schedule.
D. P.E. teachers, coaches, and trainers need cleanup baggies ready for use in classes, at athletic events, and during team practice sessions.
E. Take cleanup baggies and gloves on field trips.
F. All cleaning supplies must be labeled regardless of container.
12. Personal Hygiene Measures
A. Wash hands in soap and water immediately after evacuating bowels or bladder and always before handling food or eating.
B. Keep hands and unclean articles or utensils that have been used for bodily purposes by others away from the mouth, eyes, nose, ears, and wounds.
ROUTINE PROCEDURES FOR SANITATION AND HYGIENE
WHEN HANDLING BODY FLUIDS (Cont.)
C. Avoid using common or unclean eating utensils, drinking cups, towels, combs, handkerchiefs or disposable tissues.
D. Avoid exposure to other persons' spray from the nose or mouth as in coughing, sneezing, laughing, or talking.
E. Wash hands thoroughly after handling another person's belongings.
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